PRESENCE AMBULATORY SERVICES NPI 1124355904

NPI Information

NPI: 1124355904
Provider Name: PRESENCE AMBULATORY SERVICES

Doing Business As: PRESENCE IMMEDIATE CARE CENTER - DES PLAINES

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
150 N RIVER RD
DES PLAINES, IL
ZIP 60016
Phone: (847) 813-3510
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PRESENCE AMBULATORY SERVICES is a multi-specialty clinic center in Des Plaines, IL. PRESENCE AMBULATORY SERVICES NPI is 1124355904. The provider is registered as an organization entity type.
The provider Is Doing Business As Presence Immediate Care Center - Des Plaines.

The provider's business location address is:

150 N RIVER RD
DES PLAINES, IL
ZIP 60016-272
Phone: (847) 813-3510
Fax: (847) 297-7512

The provider's authorized official is Melvonne Wickliffe-jones .
The authorized official title is Credentialing Mgr and has the following contact phone number (630) 914-2417.

The enumeration date for this NPI number is 11/16/2009 and was last updated on 5/29/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IL2940	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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